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In a time of instant archiving and ongoing planetary collapse, literature’s engagement with the archive no longer automatically has the political purchase it had as late as the end of the twentieth...

ispartof: LIT: Literature Interpretation Theory vol:31 issue:1 pages:1-7 status: Published online

This paper combines a close reading of David Foster Wallace's largely ignored story “Death is not the End” with sociological analysis of the commodification of literary fiction under neoliberalism....

“You will be judged solely on documentary evidence.” – Hilary Mantel. A Place of Greater Safety. We first encounter Georges Danton – one of the three main characters in Hilary Mantel’s 1992 novel A...

A variety of treatment outcomes in chronic pain are influenced by patient–clinician rapport. Patients often report finding it difficult to explain their pain, and this potential obstacle to mutual understanding may impede patient–clinician rapport. Previous research has argued that the communication of both patients and clinicians is facilitated by the use of pain-related images in pain assessments. This study investigated whether introducing pain-related images into pain assessments would strengthen various components of patient–clinician rapport, including relative levels of affiliation and dominance, and interpersonal coordination between patient and clinician behaviour. Videos of 35 pain assessments in which pain images were present or absent were used to code behavioural displays of patient and clinician rapport at fixed intervals across the course of the assessment. Mixed modelling was used to examine patterns of patient and clinician affiliation and dominance with consultation type (Image vs Control) as a moderator. When pain images were present, clinicians showed more affiliation behaviour over the course of the consultation and there was greater correspondence between the affiliation behaviour of patient and clinician. However, relative levels of patient and clinician dominance were unaffected by the presence of pain images in consultations. Additional analyses revealed that clinicians responded directly to patients’ use of pain images with displays of affiliation. Based on the results of this study, we recommend further investigation into the utility and feasibility of incorporating pain images into pain assessments to enhance patient–clinician communication.

Pain consultations are often contested spaces where patient and clinician compete for the roles of speaker. Often patients are searching for mechanical explanations and clinicians for psychological ones - creating an impasse and causing distress to both parties. Meanwhile, as technology advances and we have increasing means of seeing inside a person’s body we seem to have less and less ability to see inside another’s world – to understand what it means to live with pain, the significance of that pain for that individual in their social context. In this paper we explore the potential for images of pain, co-created with patients, to intervene in this unproductive patient dynamic and bring the full experience of pain - social, emotional, physical - into focus. Narrative analysis is used on a series of transcripts of pain consultations.

The North York Moors National Park, in Northeast England, is one of the few upland areas of the United Kingdom located immediately downwind of major sulphur and nitrogen emission sources. Despite this, few studies of air pollution impacts have been undertaken, and there is no formal long-term upland water quality monitoring site. We examined the condition of surface waters in the National Park based on (1) a unique 20 year stream pH record from three locations; and (2) a snapshot survey of 51 surface waters draining moorland and conifer plantations. Interpretation was supported by sulphur isotope analysis of a subset of water samples, and a diatom survey of one of the monitoring streams. Long-term pH data for a stream draining the peat plateau demonstrate extreme, year-round acidification, with recovery only evident in the last few years. Lower-elevation sites are less acidic, but show similar temporal trends, and are characterised by frequent and severe acid episodes. The snapshot survey confirmed that acidification of the moorland area is widespread, to a degree observed in few other areas globally; out of 37 moorland streams sampled, 32 had an acid neutralising capacity (ANC) below −50 μequiv. l−1. Sulphate was found to be (by far) the dominant cause of acidification, and sulphur isotope analysis confirmed that this derives primarily from atmospheric deposition. Nitrate concentrations remain low, indicating that the organic moorland soils continue to retain most incoming nitrogen. It appears that conifer planting has exacerbated acidification, leading to fivefold higher nitrate and threefold higher aluminium concentrations compared to the moorland sites. Available biological data suggest that waters in the region have been impoverished by acidification. We speculate that the slow recovery of surface waters in the North York Moors is due to the release of a legacy of stored sulphur from the peats, released during droughts. We conclude that: (1) acidification is far from being a solved problem in this sensitive near-source upland region, despite reductions in sulphur deposition; (2) plantation forestry has exacerbated the effects of atmospheric pollution, and triggered nitrogen saturation; (3) the lack of any formal long-term monitoring in the North York Moors represents a major gap in the current evidence base for the effects of long-range air pollutants on UK upland ecosystems.